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Vol. I, No. 3 ~~~ EINet News Briefs ~~~ 01㪙㫺

****A free service of the APEC Emerging Infections Network*****

The EINet listserv was created to foster discussion, networking, and collaboration in the area of emerging infectious diseases (EID's) among academicians, scientists, and policy makers in the Asia–Pacific region. We strongly encourage you to share their perspectives and experiences, as your participation directly contributes to the richness of the "electronic discussions" that occur. To respond to the listserv, use the reply function.

In this edition:

  1. Food borne illnesses
  2. Avian flu update
  3. Overview of infectious–disease information from Pro–MED
  4. Interest survey report
  5. How to add colleagues to the EINet listserv

1. Food borne illness surveillance in the Asia–Pacific region

Although not food borne, the avian flu has resulted in major changes in the trade and sale of poultry in Hong Kong and China. The massive destruction of flocks and impact of trade disruption between the PRC and Hong Kong reminds us of how large the trade of foodstuffs in our region has become over the last decade. The increased trade of foodstuffs within EU economies has led to intensified collaborative efforts among those countries to carry out surveillance for foodborne pathogens. An example of this would be " Salmnet", the European Network for International Human Salmonella Surveillance, and increased development of surveillance laboratory techniques, such as the application of pulsed–field gel electrophoresis to the investigation of the international outbreak of Salmonella agona in 1996.

To what extent is there cooperative effort for the surveillance of food borne diseases such as Salmonella and Campylobacter in the Asia Pacific region? A brief overview of Thailand, Singapore, New Zealand, Malaysia, Philippines, Australia, Canada, Chile, Hong Kong, Indonesia, Japan, Mexico, Taiwan government health websites revealed readily retrievable information about Salmonella and Campylobacter surveillance in only Australia/New Zealand, Canada, and Japan.

Given the history of epidemic E coli in a number of economies and the concern about increasing drug resistance of salmonella in South Asia food borne surveillance should be a priority. Our overview of electronically posted information may well underrepresent the collaborative activity in this area. We invite our listserv members to share any information they may have about initiatives in food safety, foodborne illness surveillance, and collaborative surveillance efforts among APEC member countries. Thank you and Happy New Year!!!

2. Avian flu update

January 1, 1998 update: The Department of Health (DH) announces one morenew confirmed influenza A (H5N1) case today (Thursday). The case involved a 14–year–old female. She is under treatment at Princess Margaret Hospital in satisfactory condition. This brings the total number of cases to 14 confirmed cases and six suspected cases.

Confirmed cases

Case 1: Male / 3 yr Died
Case 2: Male / 2 yr Recovered and discharged
Case 3: Female / 13 yr Died
Case 4: Male / 54 yr Died
Case 5: Female / 5 yr Recovered and discharged
Case 6: Male / 37 yr Recovered and discharged
Case 7: Female / 24 yr Under treatment, condition critical
Case 8: Male / 2 yr Recovered and discharged
Case 9: Male / 4 yr Under treatment, condition satisfactory
Case 10: Male / 1 yr Recovered and discharged
Case 11: Female / 3 yr Recovered and discharged
Case 12: Female / 60 yr Died
Case 13: Female / 25 yr Under treatment, condition critical
Case 14: Female / 14 yr Under treatment, condition satisfactory

Suspected cases

Case 1: Female / 3 yr Recovered and discharged
Case 2: Male / 6 yr Recovered and discharged
Case 3: Female / 19 yr Under treatment, condition critical
Case 4: Male / 3 yr Under treatment, condition satisfactory
Case 5: Male / 7 yr Under treatment, condition satisfactory
Case 6: Male / 72 yr Under treatment, condition stable

18㪤㫹 ProMED–mail has learned that there is a cluster of influenza A H5N1 cases within a family being investigated in Hong Kong. Although the possibility of independent introductions cannot be excluded, the onset of illness in the apparent secondary cases followed the index case by 3נ days.

In other words, the HK Dept of Health has formally recognized the possibility of human–to–human transmission. On December 16th, Director of Health Dr Margaret Chan said that genetic analysis of the H5N1 virus in the first four cases so far had shown avian gene sequences while laboratory results of the other cases were pending. "This points to the fact that the transmission of the virus both from bird–to–human and human–to–human are possible," Dr Chan said, although "the efficiency of transmission from human–to–human should not be high or there should be hundreds and thousands of such cases in the territory by now, according to past experience with other types of influenza. Thus, the present cluster of cases detected in HK had not reached epidemic proportions."

ACTION: The Agriculture and Fisheries Department was in charge of slaughtering 1.3 million birds. In an operation which started on Monday, only about 20 per cent of the chickens and other poultry kept near them killed in the first day because most of the workers had no experience of handling chickens. (From the South China Morning Post online) <This step was taken in part because early serologic surveillance taken at the time of the first case suggested contact with poultry as a risk factor for surveillance––mod.>

3. Overview of infectious disease information

Here is our weekly summary of relevant Asia–Pacific postings to the ProMED Electronic Network, which is a prototype for a communications system to monitor emerging infectious diseases globally as an initiative of the Federation of American Scientists (FAS) and co–sponsored by WHO. More information about PROMED can be acquired contacting the moderator. Please contact the moderator if you would like more any of the reports below:

17㪤㫹 to 22㪤㫹

The WHO Collaborating Centre for Arbovirus Reference and Research, Queensland Health, has confirmed 21 cases of dengue 3 virus infection in Cairns, with most having a history of having stayed or visited a local hostel. Some of the cases are from people working or staying at nearby places. The virus appears to be rather virulent, with 7/21 cases hospitalised, though no DHF has been reported.

A spokesman said the latest outbreak was caused by a new variety of dengueן virus. "That concerns us greatly because the last one was type 2. When you get people being infected sequentially by two different strains they can develop dengue haemorrhagic fever," he said. Sequencing of the PCR product amplified directly from patient sera suggested that the dengue 3 virus originated from SE Asia. The virus is most closely related to a dengue 3 virus isolate obtained from a patient who returned to Australia from Thailand in 1993.

Mosquito control efforts include media pounding, house–to–house source reduction and, with great emphasis, interior fogging with residual pyrethroid insecticides. The goal at this time is to keep the virus confined to the area near the hostel.


From: Dr. Jean Blancou & Dr. Gardner Murray. A further infected farm has been detected within the declared infected zone. This third farm was within 1 kilometre of the first infected farm and is well within the 3 km surveillance zone. This third farm was a commercial broiler farm which also raised emu chicks. <As usual, detailed update report available upon request>


An Irian Jaya Health Provincial Officer reports that there is a large possibility that at least 50% of the deaths in the outbreaks in Irian Jaya and Papua New Guinea are caused by malaria, spurred by changes in the ecosystem. El Nino has caused drought conditions since April 1997 and increased the temperature in the highland, possibly broadening the climatic conditions favorable to _Anopheles punctulatus_ (?).

<According to the US National Oceanic and Atmospheric Administration, El Nino related impacts have included 1) wetter than normal conditions over the equatorial central and eastern Pacific (June–November) and over central Chile (May–August); and 2) drier than normal conditions in Indonesia (June–November), and most of Central America and Mexico (June–September). What evidence of the effects of these climatic changes have been seen by listserv members on vector borne emerging infectious diseases?>


(From the China News:) Foot and mouth disease has infected at least 211 pigs in Taiwan during the past week: Chupei, Hsinchu – 30 pigs; Taichung – 49; Kaohsiumg, Kanshan – 132. All animals have been slaughtered. This is the second outbreak of the same type of FMD in pigs this year in Taiwan, and officials believe the recurrence may be due to lapsed vaccination programs stemming from declining pork prices.

4. Interest survey report

Thank you for all of you who responded to our interest survey. Colleagues from thirteen economies responded. The results are below:

A. Which of the following would be most useful to you:

43% 1. summary of surveillance reports of outbreaks in the Asia–Pacific region from such sources as ProMED
19% 2. using network to enhance collaboration through communication
38% 3. announcing new research developments
43% 4. announcements of APEC EINet project activities and meetings
67% 5. summary of APEC conferences and summits
19% 6. all of the above

B. As you know, APEC listserve "breaks into" your email with updates to assure you are informed of the latest developments in the field. How frequently would you like this to occur:

43% 1. once a week
38% 2. once a month
10% 3. quarterly
10% 4. not at all–––prefer digest format (digest format is a form which you which you would access occasionally, independent of what was "new")

5. How to leave this list or post comments to it

The APEC EINet listserv was established to enhance collaboration among academicians and public health professionals in the area of emerging infections surveillance and control. Subscribers are encouraged to share their own material with their colleagues in the Asian–Pacific Rim by addressing comments to apec–ein@u.washington.edu. To subscribe, please contact Nedra Floyd Pautler at pautler@u.washington.edu. Further information about the APEC Emerging Infections Network is available at http://www.apec.org/infectious.

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June 25, 1998

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